A Digitized X-ray Analysis

Palmer College of Chiropractic- Invited Lecture Series

Edward F. Owens, Jr., M.S., D.C.

December 6, 1988


Radiographic procedures are often used by Chiropractors to assess the positional relationships of skeletal structures. Recent studies have, however, suggested that x-ray analysis procedures lack sufficient repeatability and validity to be considered accurate measures of skeletal position. Nevertheless, analysis of plane x-rays remains a very popular method for detecting misalignments that might represent subluxation. An x-ray analysis project is in progress at Life Chiropractic College with the goals of determining the sources of error in x-ray analysis and finding methods for controlling error.

The project centers around an Upper Cervical Analysis and adjusting technique that uses carefully regimented radiographic procedures and analytical techniques to determine Atlas and Axis misalignment with respect to the skull. A Sonic digitizer, interfaced to an IBM-compatible computer and monitored by custom software is used to store the locations for skeletal landmarks for later calculation of misalignment factors.

Digitized analysis offers the advantages of eliminating the operator errors associated with line drawing and angular measurement; allowing detailed assessment of operator from the out come of measurements.

The methodologies and preliminary results of two studies using a digitized analysis will be described. The first is a repeatability study assessing the ability of operators to locate skeletal landmarks on radiographs. A second study of a new Lateral Cervical x-ray analysis is being performed to test the sensitivity of measures of cervical curvature to the presence of cervical disorders.